An integrative review of the influence of job strain and coping on nurses' work performance: Understanding the gaps in oncology nursing research

Suicidal ideation and their relationship with job satisfaction and job strain among Jordanian hospitals' healthcare professionals: a cross-sectional study

Suicidal ideation is a major health problem that occurs in response to complex interactions among psychological, sociocultural, and environmental factors. The phenomenon of suicidal ideation among healthcare professionals is still shrouded in mystery in Jordanian society, and there is still a scarcity of studies on its relationship with job strain and job satisfaction has been examined in the Arab world. Therefore, to fill this gap, this study aimed to reveal the prevalence of suicidal ideation among Jordanian hospitals health care professionals, and its relationship to job satisfaction and job strain. Additionally, how some sociodemographic factors were correlated with suicidal ideation levels, including age, sex, monthly income, occupation, years of experience, and sector type. Data were collected through a survey including sociodemographic characteristics, Suicidal ideation Scale (SIS), Job Satisfaction Survey (JSS), and Demand Control Support Questionnaire (DCSQ). The survey was distributed among 910 physicians and nurses of both sexes in public and private Jordanian hospitals. The survey was conducted using an anonymous online platform via Google Forms between October 2022 and December 2023. In light of the strain theory of suicide (STS), our results showed that physicians and nurses reported low levels of suicidal ideation and job satisfaction, with high levels of job strain. Suicidal ideation was positively correlated with job strain and negatively correlated with job satisfaction. Job satisfaction is negatively correlated with job strain. Job satisfaction was a significant mediator between job strain and suicidal ideation. Greater attention should be paid to the work environment in healthcare, particularly to enhance social support, increase job satisfaction levels, reduce job strain, and provide extensive training on effective prevention strategies for suicidal ideation and behaviour in the workplace. Additionally, policies and practices related to the health sector should be modified to create stable, healthy, and safe relationships and work environments.

The cancer nursing workforce in Australia: a national survey exploring determinants of job satisfaction

BACKGROUND

To maintain and improve the quality of the cancer nursing workforce, it is crucial to understand the factors that influence retention and job satisfaction. We aimed to investigate the characteristics of cancer nurses in Australia and identify predictors of job satisfaction.

METHODS

We analysed data from an anonymous cross-sectional survey distributed through the Cancer Nurses Society Australia membership and social media platforms from October 2021 to February 2022. The survey was compared to national nursing registration data. Data were analysed with non-parametric tests, and a stepwise, linear regression model was developed to best predict job satisfaction.

RESULTS

Responses were received from 930 cancer nurses. Most respondents (85%) described themselves as experienced nurses, and more than half had post-graduate qualifications. We identified individual, organizational, and systemic factors that contribute to job satisfaction and can impact in workforce shortages. The findings include strategies to address and prioritize workforce challenges. There were 89 different titles for advanced practice nursing roles. Managing high workload was a reported challenge by 88%. Intention to stay less than 10 years was reported by nearly 60%; this was significantly correlated with job satisfaction and age. Significantly higher scores for job satisfaction were associated with those who had career progression opportunities, career development opportunities, adequate peer support and a clearly defined scope of role. Conversely, job satisfaction scores decreased the more people agreed there was a lack of leadership and they had insufficient resources to provide quality care.

CONCLUSION

Cancer nurses are critical to the delivery of cancer care however, the workforce faces multiple challenges. This study provides an understanding of the Australian cancer nursing workforce characteristics, their roles and activities, and highlights important considerations for retaining nurses in the profession.

"Suddenly Feeling Dark": A Qualitative Study on the Experiences of Nurses Facing Coworker Death During the COVID-19 Pandemic

BACKGROUND

The coworkers of nurses who died because of COVID-19 infection generally experience a highly emotional grieving process. Nurses grieving the loss of a coworker during the COVID-19 pandemic experience higher psychological stress because of their high workload and the grueling shifts required to manage health emergencies during the pandemic and cope with long-standing staffing shortages. The limited number of studies discussing this issue has resulted in insufficient evidence necessary to develop effective counseling strategies and psychological support for nurses in Indonesia dealing with the massive waves of COVID-19 cases.

PURPOSE

This study was designed to elucidate the experiences of nurses across four provinces in Indonesia who had experienced the loss of a colleague during the COVID-19 pandemic.

METHODS

A qualitative research design and phenomenological approach were used in this study. Sampling was done in Jakarta, Bali, East Java, and East Nusa Tenggara using purposive sampling for the first eight participants and snowball sampling for the subsequent 34 participants. Semistructured, in-depth interviews were used to collect data from 30 participants using appropriate ethical principles. Data saturation was achieved after interviewing 23 participants, and their data were analyzed using thematic analysis.

RESULTS

Three main themes related to nurses' responses to the death of a colleague, distinguished into several stages, were identified. Stages in the first theme were as follows: (a) shocked to hear of colleague's death, (b) self-blame for failing to save a life, and (c) afraid to experience the same situation. Stages in the second theme were as follows: (a) make efforts to avoid the same thing from happening again, (b) develop strategies to avoid thoughts of loss, and (c) expect to have a psychological support system. Stages in the third theme were as follows: (a) seek new reasons, goals, directions, and meanings in life and (b) improve the physical and social health of individuals.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The range of responses from nurses to the death of a colleague during the COVID-19 pandemic identified in this study may be referenced by service providers to better provide psychological assistance and support to nursing staff. In addition, the coping strategies described by the participants provide detailed information that healthcare providers may use to deal with nurses facing death more comprehensively. This study emphasizes the importance of developing strategies to help nurses cope positively with their grief from a holistic perspective, which may be expected to impact positively the performance of nurses.

THE RELATIONSHIP BETWEEN PSYCHOSOCIAL WORK ENVIRONMENT AND NURSES' PERFORMANCE, ON STUDIES THAT USED THE VALIDATED INSTRUMENT COPENHAGEN PSYCHOSOCIAL QUESTIONNAIRE (COPSOQ): AN EMPTY SCOPING REVIEW

OBJECTIVE

Aim: This study was to map the relationship between psychosocial work environment and nurses' performance, on studies that used the Copenhagen Psychosocial Questionnaire (COPSOQ).

PATIENTS AND METHODS

Materials and Methods: The review intended to answer following questions: 'Can COPSOQ screen completely psychosocial risks of nurses' work environment?' 'Which of these dimensions affect more nurses psychosocial world? A scoping review was developed guided by the JBI methodology and using PRISMA-ScR.

CONCLUSION

Conclusions: Hospital workers, and in particular nurses, are exposed to different risk factors with the most important being psychosocial risks. These arise from problematic work planning, organization and management, as well as from an unhealthy social context of work and may lead to negative psychological, physical and social outcomes. The review highlighted the need for further research using the entire COPSOQ questionnaire in order to fully study the psychosocial risks that nurses face in their work environment.

Australian cancer nurses' experiences of burnout: Exploring the job demands and job resources of metropolitan cancer nurses during 2019-2020

BACKGROUND

Existing studies that seek to understand nurses' experiences of burnout are dominated by cross-sectional, quantitative survey designs employing predetermined measures, often overlooking important job-related stressors that can be highly dependent on industry and professional contexts. Cancer nurses are a group of professionals who warrant special attention, as burnout in this profession is often attributed to high job demands and the challenge of caring for a vulnerable cohort of patients. A deeper understanding of the job demands associated with cancer nursing is required to provide insights about the work experiences of cancer nurses and identify aspects that mitigate burnout and stress.

PURPOSE

This study describes the antecedents of burnout among Australian cancer nurses by focusing on the demands and resources inherent in their work. We aim to build on the existing literature by identifying job resources that may serve to mitigate the antecedents of burnout.

METHODOLOGY/APPROACH

An in-depth interview study of cancer nurses across a spectrum of age and experience in Australian metropolitan public health care services was conducted over a 2-year period that coincided with the COVID-19 pandemic. The job demands and resources model framed this study of job-related factors associated with burnout and conversely job resources that may foster work engagement.

RESULTS

Patient aggression, workload, emotional demands, and abusive peers and managers were reported as distinct job demands, whereas job significance and supportive peers who demonstrated leadership, along with task variety, were identified as job resources.

CONCLUSION

Australian cancer nurses work in an environment where job demands are increasingly disproportionate to job resources, leading to significant risk of burnout.

PRACTICE IMPLICATIONS

Our study identifies modifiable strategies for improving work conditions for this group who play a critical role in the health care system.

Anxiety level among newly hired nurse in a specialized oncology hospital: An observational study

Background: Anxiety is common among oncology nurses due to the complexity of oncology patients' needs and demands. The current study aimed to assess the anxiety level among newly hired nurses in a specialized oncology hospital throughout their initial period of employment, deploying a General Nursing Orientation (GNO) and the Clinical Resource Nurse (CRN) role.

Methods: A longitudinal one-group repeated measure design was used. Participants' demographics sheet and Sate-Trait Anxiety Inventory for Adults questionnaire were used. A total of 181 newly hired nurses participated in the study.

Results: The anxiety level among newly hired oncology nurses was (mean=38.65, SD=9.58) at the beginning of GNO, and the level of anxiety was highest after 90 days of employment (mean=45.71, SD=7.20). The level of anxiety among newly hired oncology nurses increased gradually from day one of the GNO, the last day of GNO, and finally, after 90 days of employment.

Conclusions: Nurses working in oncology workplaces face anxiety. It is important to seek nursing administrators' attention to apply proper strategies to decrease the anxiety level among newly hired nurses to help them smoothly fit into a new team to ensure safe patient care.

Missed nursing care: Testing the moderation-mediation energetic and motivational pathways via a nested design

AIMS

To examine: (1) a motivational pathway where head nurse proactive leadership and nurse vigour are linked, which in turn correlates to missed nursing care, and might be moderated by workload; and (2) an energetic pathway where workload and nurse exhaustion are linked, which in turn correlates to missed nursing care, and might be moderated by head nurse proactive leadership.

DESIGN

A cross-sectional design, with nurses nested in wards.

METHODS

During 2018, 196 nurses from 37 wards completed questionnaires that included the 22-item MISSCARE survey; the 6-item Work Demand subscale; the 10-item Proactivity Personality scale; the 5-item Exhaustion subscale of the Maslach Burnout Inventory; the 5-item Vigour subscale of the Work Engagement scale; and nurse's and head nurse's sociodemographic characteristics. Moderation-mediation models were performed using mixed-linear model analyses.

RESULTS

A moderation-mediation motivational pathway was supported. Specifically, nurse vigour was higher under low workload when head nurse proactive leadership was high (β = -.09, p = .050), which in turn was associated with lower missed nursing care (β = -.10, p = .045). Yet, a moderation-mediation energetic pathway was not supported. Specifically, nurse exhaustion was lower under low workload when head nurse proactive leadership was high (β = .14, p = .032), but no association was found between exhaustion and missed nursing care.

CONCLUSIONS

This study shows that there is a significant role for nurse agency and nurse ability to cope with scarce resources.

IMPACT

To date, research has focused mainly on the assumption that missed nursing care is a result of scarce resources. Findings indicate that even under scarce resources, nurses can be motivated to reduce missed nursing care. Emphasis should be placed on promoting and maximizing nurse motivation. This can be achieved by developing and implementing interventions of proactive leadership of head nurses.

The Relationship between Moral Sensitivity, Ethical Climate, and Job Strain with Patient Privacy from Viewpoint of Operating Room Staffs

BACKGROUND

The privacy of patients in the operating room is in particular importance. The results of previous studies have shown that various factors are affecting in this context. The aim of this study is to evaluate the relationship between moral sensitivity, ethical climate, and job strain with respect to patients' privacy in operating rooms.

MATERIALS AND METHODS

All of operating rooms nurses of teaching hospitals affiliated to Ardabil University of Medical Sciences were entered into this descriptive-analytical study with census sampling method in 2019. To collect data, standard surveys of moral sensitivity, ethical climate, job strain, and privacy were used. Data were analyzed by SPSS15 software using descriptive and analytical statistics methods (independent t-test, ANOVA, Pearson correlation, and regression analysis).

RESULTS

There was a positive significant relationship between moral sensitivity and privacy (r = 0.56, p < 0.001) and ethical climate and privacy (r = 0.60, p < 0.001), too. But, there was an inverse and significant correlation between job strain and privacy (r = -0.69, p < 0.001). The results also showed that moral sensitivity is the best predictor of patients' privacy.

CONCLUSIONS

Despite the predictability of all variables, results showed that moral sensitivity is the most important component in patients' privacy. In this regard, by increasing the moral sensitivity of nurses, the privacy of patients can be improved.

Spiritual Coping with Stress Among Emergency and Critical Care Nurses: A Cross-Sectional Study

A cross-sectional study using Spiritual Coping Questionnaire (SCQ) to explore the spiritual stress coping among Muslim Emergency and Critical Care nurses. 113 Participants were recruited. SCQ demonstrated good validation estimates. Positive religious behavior was the main spiritual coping with job stress. Likewise, spiritual coping was highly perceived as religious. Critical care nurses reported significantly higher positive social coping. Nurses with longer work experiences were significantly better in positive spiritual coping. Spiritual coping practices are highly prevalent in healthcare settings despite still lacking integration of spiritual components in its physical infrastructure, health policy and management.

Secondary Traumatic Stress, Mental State, and Work Ability in Nurses-Results of a Psychological Risk Assessment at a University Hospital

Psychological risk assessment is a legal obligation for companies and part of occupational safety and employment protection in Germany. However, data from psychological risk assessments in nursing staff are scarce, although this population is at increased risk for secondary traumatic stress by patient experienced trauma. Therefore, our study aimed at examining the frequency of reported secondary trauma events, secondary traumatic stress, and its possible consequences for psychological well-being and work ability in nurses. N = 320 nurses (n = 280 female) were assessed at a University Hospital in Germany as part of the psychological risk assessment. Secondary traumatic events, secondary traumatic stress, and symptoms of depression and anxiety were measured using self-report questionnaires (PHQ-2, GAD-2), and work ability was assessed using a modified version of the questionnaire for workplace analysis (KFZA). Of 320 nurses, 292 (91.2%) experienced secondary trauma, and 74 nurses (25.3%) reported secondary traumatic symptoms. Nurses with secondary traumatic symptoms reported higher depression (p < 0.001) and anxiety scores (p < 0.001) compared to nurses without secondary trauma experience, and to nurses with secondary trauma experience but without secondary traumatic stress (both p < 0.001). Further, nurses with secondary traumatic stress reported significantly reduced work ability, social support and control over work, and increased emotional strain and labor time. Nurses with secondary traumatic stress may be at increased risk of developing major depression and anxiety disorders, and particularly need support in overcoming secondary traumatic experiences. Psychological risk assessment is a useful tool to identify groups at risk, and pave the way to implement strategies to improve mental well-being and prevent work ability in high risk groups.

The role of organizational factors in nurse burnout: Experiences from Iranian nurses working in psychiatric wards

Introduction:

The optimal performance of a healthcare organization is one of the effective factors in increasing the efficiency and productivity of nurses and thus reducing their burnout. The aim of this study was to investigate the role of organizational management on nurse burnout based on experiences from Iranian nurses working in psychiatric wards.

Materials and Methods:

This qualitative study was conducted on 15 nurses working in psychiatric wards selected through purposive sampling. Data collection was done through in-depth semi-structured interviews in psychiatric wards in Ahvaz (southwest of Iran) and Tehran. Data analysis was done through conventional content analysis.

Results:

The findings included one main category and three subcategories. The main category was “Providing care at an inadequate organization,” and the three sub-classes namely “Shortages of human resources,” “Shortage of physical resources,” and “Impact of management approaches to care provision” were extracted.

Conclusion:

The results of this study showed that inadequate supply of equipment and human resources along with ineffective managerial approaches in the organization could lead to mental and emotional exhaustion, negative attitudes toward the profession, decreased and poor service quality, employee turnover, and early retirement of nurses in psychiatric wards. Therefore, by adopting appropriate policies in their programs, paying special attention to the physical and mental health of nurses, and addressing their problems, managers of healthcare organizations can motivate and sustain the human resources within the organization.

Psychosocial work environment and cross-cultural competence among native and foreign-born registered nurses

Cross-cultural competence is an essential component of the nursing profession, but little is known about the specific psychosocial work characteristics that potentially promote or hinder such competence. In the present study, psychosocial work characteristics were based on Karasek's Job Demand-Control Model. The researchers examined whether Karasek's psychosocial work characteristics, such as high-strain jobs, high-strain isolated jobs, active jobs, and active collective jobs, are associated with cross-cultural competence (empathy, skills, positive attitudes, and motivation), and whether there are differences between native and foreign-born registered nurses (RN) in these potential associations. A random sample of 744 native RNs (91.0% women) and a total sample (n = 212) of foreign-born RNs (94.3% women) working in Finland were used. Data were collected using a questionnaire and analyzed with a series of multiple linear regression analyses. High-strain and high-strain isolated jobs were negatively associated with all four dimensions of cross-cultural competence. Active collective jobs, but not active jobs, were positively associated with cross-cultural skills. There were no differences between native and migrant nurses in these associations. The psychosocial work environment is associated with cross-cultural competence in both native and migrant nurses. Improvements in psychosocial working conditions, especially minimizing negative factors in the work environment, such as high-strain and high-strain isolated jobs, may need to be considered as a part of the efforts aimed to enhance cross-cultural competence among nursing personnel.

Effect of Workload on Job Stress of Ghanaian OPD Nurses: The Role of Coworker Support

Background

Although the concept of workload is important to nursing practice, only a few nursing researchers have focused on the issue of workload within the nursing context. Knowledge of how the dynamics of workload affects the job stress of nurses working in a specific unit or department in a hospital setting, and the influence of coworker support on this relationship, still remains limited. This study, therefore examined the effect of workload on job stress of Ghanaian outpatient department nurses and the moderating effect of coworker support on this relationship.

Methods

A cross-sectional survey design was used, and questionnaire was used to collect data from a sample of 216 outpatient department nurses from four major hospitals in Ghana. The data collected measured workload, job stress, and coworker support using National Aeronautics and Space Administration (NASA) Task Load Index, job stress scale, and coworker support scale, respectively. Data were analysed using descriptive statistics, correlation, and hierarchical regression.

Results

High levels of workload were associated with high levels of job stress of the nurses. Also, higher levels of workload were related to higher levels of job stress for nurses who received high levels of coworker support, but this was not the case for those who received low levels of coworker support (reserve buffering effect).

Conclusion

The finding reiterates the adverse effect of workloads on employees' health, and the reverse buffering effect implies that supporting a colleague at work should be conveyed in a positive manner devoid of negative appraisal.